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Friday, December 12, 2008

Millions of lives are saved each year through blood transfusions. In many developing countries, people still die due to an inadequate supply of blood and blood products. A reliable supply of safe blood is essential for scaling up health at several levels, particularly for women and children. For instance, more than half a million women die every year from complications related to pregnancy and childbirth worldwide (99% of them in developing countries). Hemorrhage (blood loss) accounting for 25% of the complications, is the most common cause of maternal death. Malnutrition, Thallasaemia and severe Anemia are the major diseases prevailing in children. Over 80 million units of blood are donated every year around the world, but only 39% is collected in developing countries where 82% of the global population lives. Up to 70% of all blood collection in Pakistan are given to children with Thallasaemia, which accounts for about one in ten of all childhood deaths in Pakistan.Too many countries still rely on family replacement (a member of the patient's family donating his/her blood) or paid donors. Although Pakistan has increased its voluntary unpaid blood donation in the last five years to 20% of its blood supply, replacement donors made up 70% and paid donors 10% of blood supplies in 2005.Family replacement donors may feel under pressure to donate and may therefore hide aspects of their health and lifestyle, which could mean that their blood is more likely to contain infection. In the case of paid donors, governments may think that the financial incentive will motivate more donation and boost supplies, but paid donors are often pushed by need and are therefore also more likely to avoid mentioning important details about their health status.Experience has shown that the safest donor is one who gives blood at least twice a year without receiving money or goods in exchange, understands the principle of altruism, answers questions for donor selection honestly, and will defer or exclude him/herself from donation if there is any risk to the recipient. Because such donors generally have a sense of responsibility towards their community, they tend to keep themselves healthy so as to be able to keep giving safe blood.

IMPORTANCE OF BLOOD

Wherever you are in the world, blood has very important cultural meaning. It is often seen as a life force, and as a symbol of family and kinship ties. It may even equate with personality and appearance.

Blood carries vital nourishment to all the tissues and organs of the body. Without blood the tissues die of starvation. In the womb, for example, the mother's blood ensures that the foetus is supplied with oxygen and nutrients and benefits from the mother's inbuilt defenses against diseases. The average person has 25 billion red blood cells, and in a normal healthy person cells are constantly regenerated in the body.About 45 per cent of the total volume of blood is made up of:Red Blood CellsWhite Blood Cells Platelets The remaining 55 per cent is called plasma. Red blood cells carry oxygen. The hemoglobin, which gives blood its red color, is the agent, which needs to be present for oxygen to be taken up from the lungs. Iron is a key factor in the manufacturing of hemoglobin. When iron is low, people become anemic, with a corresponding loss of oxygen-carrying ability. Red blood cells also transport the used oxygen, transformed into carbon dioxide, back to the lungs for expulsion from the body.

White blood cells defend the body against disease. They make antibodies (natural defenses produced in the body against infection) and fight infections.

Platelets help to control bleeding by sticking to injured surface of blood vessels, and allowing clotting factors to accumulate at the injury site.Plasma is a fluid, which carries all these cells, plus other substances such as proteins, clotting factors and chemicals.

Sometimes, through trauma such as hemorrhage (blood loss), the volume of blood in the body reduces to such level that the body cannot replace it fast enough. Occasionally, the blood is faulty, and does not function properly, as in the case where clotting does not occur, as in hemophilia (inherited blood disorder), and where the body doesn't make blood that is called Thallasaemia. At other times, the blood does not produce sufficient hemoglobin. In many of these cases, blood products will transfuse into patients. All the different components of blood can be used and each component plays an important role in saving the lives of different individuals in the community.

A healthy person can safely donate Blood every 56 days (4-6 times/year). After each withdrawal of blood it takes only 36 hours for the body to reconstitute the fluid volume and 21 days for the red blood cells to return to a normal level.Education and information over a period of time can overcome all barriers to blood donation.

COMPONENTS

MAIN USES

Red Blood Cells

Hemorrhage in child birth

Surgery

Trauma, such as accidents

All kinds of anemia which cannot be medically corrected, such as cancer, sickle cell disease, Thalassaemia

Plasma

Loss of volume, as in surgery or childbirth

Plasma derivatives:

Immunoglobulins

Albumin

Coagulation factors

Various preventative uses

Burns

Hemophilia, liver diseases

Platelets

Bone marrow failure, leukemia

BLOOD AS THERAPY

We know that blood is not only a living tissue, but also a renewable one, with healthy people having the mechanism to make more blood. Blood can be easily given, with no fear of habit of donation weakening a person, leading to infertility or hastening the aging process. But when it comes to use of the blood, did you know that blood is used by hospitals not only as a treatment but also for prevention?Every minute of the day, blood products are being used for people who are exposed or at risk. In this category fall numerous immunoglobulins, which are used, for example, to treat abnormal functions of the immune system. Many hemophiliacs are able to lead normal lives if they are given clotting factors such as Factor VIII, a component of plasma.Blood transfusion is employed routinely in cases of surgery, trauma, gastrointestinal bleeding, and in childbirth where a great loss of blood occurs. Cancer patients also often require blood transfusions. Some genetic diseases affect the blood, such as Thalassaemia and sickle cell disorder. The shape of blood cells may be affected leading to impaired functioning. Persons with these diseases require regular supplies of safe blood to replace their deficient blood.

BLOOD SAFETY

The emergence of HIV in the 1980s and Hepatitis B & C in 1990's highlighted the importance of ensuring the safety, as well as the adequacy, of national blood supplies. In many countries, even where blood is available, many recipients remain at risk of transfusion-transmissible Diseases (TTDs) as a result of poor blood donor recruitment and selection practices and the use of untested units of blood.

Since those early days, blood services around the world have devised a wide range of measures to help make blood safer for transfusion. These include: -

i Pre donation medical interview and counseling.

ii Education of the peoples about risk factors (behaviour which may expose people to the risk of acquiring transfusion-transmissible) which contaminate blood and cause diseases that can be transferred from one person to another through blood.

iii Testing of blood for Hepatitis B, C & HIV I & II to ensure that infected blood is not given to anybody and discarded.Even with all these measures in place, it can never be claimed that blood is 100 per cent safe. Blood may be considered a powerful drug, and like all drugs, it may have side effects. There will always remain a low level of risk in blood transfusion. As a consequence we need to improve health in general and decrease the incidence of the kinds of diseases, which often need transfusion therapy.

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